Does a List of the Top EP's for Ablations Exist? If Not, Why Not?

I have a very popular a-fib blog and one of the most common questions I get asked from people that email me is: how do I find these "expert EP's" you say is so important to find if you're going to have an ablation?

I of course tell them Dr. Natale, but not everyone can fly to Texas or California to be treated by him. I hate telling people that Natale is the only option. He may be the best option, but again, not everyone can be seen by him so I'd like to give them other options. It really bums me out when they tell me Natale isn't an option and I have no other options to give them.

If such a list exists, can someone post it here? If such a list doesn't exist, why not? I wouldn't think it would be that hard to do. There should be at least one top EP for every general region of the U.S. (i.e. Pacific Northwest, West, South, Southeast, East, and Midwest). Natale covers the south and perhaps the West, so that only leaves 4 more EPs to find to start a basic list, right?

Travis

I'm no expert, but if I needed an ablation and I couldn't go to Dr. N, I'd select from the presenters at the annual ISLAA Symposium.

[islaasymposium.com]

Would a presenter automatically be manually skilled? I was once seeking a GI doctor and someone was described to be as an artist with a scalpel. I am copy /,pasting potential EPs from George’s link who are artists with a catheter:

Amin Al-Ahmad, MD
Texas Cardiac Arrhythmia Institute
Austin, TX

Krzysztof Bartus, MD
Jagiellonian University
Krakow, Poland

Jie Cheng, MD
Baylor College of Medicine
Houston, TX

James Cox, MD
Northwestern University
Evanston, IL

Thomas Deering, MD
Piedmont Heart Institute
Atlanta, GA

Luigi Di Biase, MD, PhD
Albert Einstein College of Medicine at Montefiore Hospital
New York, NY

Sephal Doshi, MD
Pacific Heart
Santa Monica, CA

Christopher Ellis, MD
Vanderbilt University
Nashville, TN

Aloke Finn, MD
CV Path Institutue
Gaithersburg, MD

Gregory Fontana, MD
HCA
Thousand Oaks, CA

Jalaj Garg, MD
Loma Linda University
Loma Linda, CA

Rajesh Gopinathannair, MD
Kansas City Heart Rhythm Institute
Overland Park, KS

Edip Gurol, MD
Massachusetts General Hospital
Boston, MA

David R. Holmes Jr. MD
Mayo Clinic
Rochester, MN

Rodney Horton, MD
Texas Cardiac Arrhythmia Institute
Austin, TX

Ken Huber, MD
Saint Luke's Mid America Heart Institute
Kansas City, MO

Chetan Huded, MD
Mid America Heart Institute
Kansas City, MO

Rajesh Kabra, MD
Kansas City Heart Rhythm Institute
Overland Park, KS

Saibal Kar, MD
Los Robles Medical Center
Thousand Oaks, CA

Sheila Kar, MD
Sutter Medical Center
Sacramento, CA

Scott Koerber, MD
Kansas City Heart Rhythm Institute
Overland Park, KS

Subramanyan Krishnan, MD
Smidt Heart Institute at Cedars Sinai Medical Center
Los Angeles, CA

Dhanunjaya Lakkireddy, MD
Kansas City Heart Rhythm Institute
Overland Park, KS

Thorsten Lewalter, MD
University of Bonn
Boon, Germany

Robert Lyons, MD
St. Joseph Mercy
Ann Arbor, MI

Sunil Mankad, MD
Mayo Clinic
Rochester, MN

Moussa Mansour, MD
Massachusetts General Hospital
Boston, MA

Devi Nair, MD
University of Arkansas Medical System
Jonesboro, AR

Andrea Natale, MD
Texas Cardiac Arrhythmia Institute
Austin, TX

Brian O'Neil, MD
Temple University
Philadelphia, PA

Abdi Rasekh, MD
Texas Heart Institute
Houston, TX

Vivek Reddy, MD
Mt Sinai Hospital
New York, NY

Ahmed Romeya, MD
Midwest Heart & Vascular
Overland Park, KS

Jacqueline Saw, MD
Vancouver General Hospital
Vancouver, Canada

Horst Sievert, MD
Cardiovascular Center
Frankfurt, Germany

Lars Sondergaard, MD
Copenhagen University Hospital
Copenhagen, Denmark

Katherine Trivedi, MD
FDA
Washington, DC

David Tschopp, MD
Texas Cardiac Arrhythmia Institute
Austin, TX

Mohit Turagam, MD
Mt. Sinai
New York City, NY

Fantastic Susan!

Thanks Susan!

I'm going to add another doctor to this list:

Pasquale Santangeli, MD, PhD

Maybe we can just keep this thread going with top EP's - or EP's that people have had success with.

Travis

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susan.d
Would a presenter automatically be manually skilled?

You'd need to do more due diligence, but if they are on this list & they are skilled enough (been through a fellowship where this is taught as not all programs do) to be working in and around the LLA, they are in the upper tier, in my book.

Pasquale Santangeli, who is now at Cleveland Clinic, would near the very top of the heap for me, should Andrea Natale not be available to a given Afibber.
A long list like this can be somewhat useful. But the bigger the list then generally the rule of thumb is that the more variable the benefit might be.

Keep in mind your targeted procedural needs and focus on the top handful of Elite operators who essentially do almost only these advanced Ablations at high volume centers.

Dr Santangeli is a truly elite operator in his early prime and yet has had as great of an education as you will likely ever find ...

For many years he mentored under Natale until Natale encouraged him to accept the offer from Frank Marchlinski head of the also elite Univ. of Penn program where Dr. Santangeli mentored for about 7 to 8 years at University of Penn.

Just this past Fall 2022, Dr. Santangeli was awarded a high honor position at Cleveland Clinic that Dr. Natale also encouraged Dr. S. to accept.

I can tell you with strong conviction that these are among the very best EPs you are likely to find.

Take care,
Shannon



Edited 1 time(s). Last edit at 05/30/2023 04:55PM by Shannon.

Posting this because I've been a UMMC CCU patient, so it's in my region -- Dr. Aloke Finn is an interventional cardiologist at University of Maryland Medical Center, not an EP as far as I know. You could certainly contact his office for more info if you're in this area. [www.umms.org]

I personally saw one of these presenters for a consultation and he told me that my case was too complex for him. So not sure if all of these folks are at the same level of expertise - especially in complex cases.

Even the top EP's do not always get the results hoped for - as good as Natale is, he still has his share of do overs.

My last ablation "touch up" number 2 - 4 years ago at CC - which is a high-volume place, has not resolved my afib issue and still on drugs to keep me in rhythm. The EP that did the procedure was not one of the top folks there I later found out. He presents often at various venues and likely has good outcomes with less complex cases. He offered to try again but did not appear to be very eager to do so nor refer me to a colleague.

Complex cases require an EP that likes a challenge and has a history of taking on those types of cases and will share their success record. Finding the right match at these centers is the challenging part. One EP I am interviewing read my case records and told me that the last EP did not complete the circuit because how close it was to the phrenic nerve. He told me what he would do to mitigate the risk for that area if that is where the issue is. I won't go into the details of his technique, but it gave me confidence. Also mentioned that the Pulsed field ablation would be safer for me given the location of where he believes where the issue is. Also, the technology and mapping has improved in the last 4 years.

It seems to me that many of the failures of first RF ablation, and a touchup that follows, has to do with where they get to with the lesions and where they run out of security, for want of a better word. Each physician has their limit, and they know what it is if they are people of integrity and courage. If they get to lesion #58, and it is starting to look like they're likely to dramatically increase the risk to the patient with any further moves to the left/right, they know they must stop and hope the curing process where lesions close up and heal against each other might be sufficient. Clearly, in maybe 15% of all cases, it isn't. And it really isn't their fault, especially if they have no experience or training in going beyond the routine PVI.

And, yes, even the highly regarded Dr. Andrea Natale has to back off at some point so as not to endanger a critical component of the heart's physiology, or of something proximal to the area where he runs out of room. And if that is precisely where the spurious signal will continue to make the heart to a jig, he will have failed. The probability of success remains with the most experienced and highly trained EPs. When they have played their best card and been trumped.............

I would say you also missed Dr. Pierre Jais and Dr. Melize Hocini in Pessac (Bordeaux) France. In my books, they’re easily as good as Natalie.

Monty

I'd add:-

[www.massgeneral.org]

He did my PVI ablation a dozen or so years ago at Mass General

Which dr on the the links list?

New to the group. I have found a lot of helpful information and support from reading your posts. I had an ablation in 2023 and will need another one. I have contacted Dr. Natale's office and was told to have my cardiologist fax a referral. I was then told that my name/case will be added to the list of other potential patients. Hopefully, I have done all that I need to do. Maybe some of you have experienced this journey. Patience is a virtue.

I am curious if any of you have gone to Dr. Natale or another top notch EP from that list for an ablation but your insurance would not cover it.

I have Kaiser so I have stay in network or pay a ton of money or at least I assume it would be a ton of money with all the labs and tests they would need before even having the procedure plus the procedure itself and assume an overnight stay in the hospital. Unless they would accept previous tests I have already had like ECG's, holder monitor, echocardiograms, etc, etc. from Kaiser?

Did you speak with Norma? She arranges Dr. Natale’s ablations for those traveling from out of town. If you did not speak with her, I can give you her contact information if you’re interested.

Quote

Unless they would accept previous tests I have already had like ECG's, holder monitor, echocardiograms, etc, etc. from Kaiser?

They should accept your Kaiser tests if they are recent. They accepted all my medical records, but Natale wanted me to get a more recent echo which my local EP provided and sent.

Please see my earlier post and if you are interested in going to Natale, speak with Norma and she can clarify your insurance situation.

Yes Daisy I know you had mentioned that. I did call the facility in Thousand Oaks. I don't remember what her name was but she didn't seem to know much and was in hurry to get off the phone. I suppose I should try calling the facility in Texas. I just want to know if they would provide an estimate or maybe they can't since ablation can require more time in some cases

Yes, I would love to get Norma's contact info if you don't mind.

Quote
EricY
I suppose I should try calling the facility in Texas. I just want to know if they would provide an estimate or maybe they can't since ablation can require more time in some cases.

I don't think Texas will be able to help you with this. Call Thousand Oaks again (and again) until you get someone who can help. As for cost, if Kaiser covers it then that will be your deductible plus any copays you have.

Quote
EricY
Yes Daisy I know you had mentioned that. I did call the facility in Thousand Oaks. I don't remember what her name was but she didn't seem to know much and was in hurry to get off the phone. I suppose I should try calling the facility in Texas. I just want to know if they would provide an estimate or maybe they can't since ablation can require more time in some cases

Yes, I would love to get Norma's contact info if you don't mind.

Norma is in Austin as that is where Natale is based. There are reasons to go to Austin if you are considering Natale. One is better followup care which is excellent out of Austin.
Norma Bazerghi RN, MSN, MBA

Single Trip Procedure Coordinator forAndrea Natale M.D.

Texas Cardiac Arrhythmia

Direct Line: 512-615-6205

Quote
EricY
I am curious if any of you have gone to Dr. Natale or another top notch EP from that list for an ablation but your insurance would not cover it.

I have Kaiser so I have stay in network or pay a ton of money or at least I assume it would be a ton of money with all the labs and tests they would need before even having the procedure plus the procedure itself and assume an overnight stay in the hospital. Unless they would accept previous tests I have already had like ECG's, holder monitor, echocardiograms, etc, etc. from Kaiser?

No you don’t. I had Kaiser from 1952-2006 and our family called up membership services. I even got Kaiser to reimburse 100% at an overseas hospital when I was a tourist and my mom, dad and brother were allowed out of network treatment as well in CA. You know Kaiser pays for treatment outside their radius. It’s either 25 miles or 50. Our family in California just called up membership services and persuaded Kaiser to pay for private out of network treatment and hospitalization.

Call up MEMBERSHIP SERVICES and persuade Kaiser to refer you to Scripps in San Diego. I believe Natale does ablations once a month from Monday to Wednesday mornings at La Jolla. Be your own advocate and be aggressive for your rights. Ask and request Kaiser/Scripps Partnership for Cardiac Care. See the next paragraph:

AI Overview
As a Kaiser Permanente Southern California member, your ability to get care at Scripps Hospital in La Jolla depends on the type of care needed (emergency vs. non-emergency) and your specific plan's out-of-network benefits.
Emergency Care at Scripps Hospital
Yes, Kaiser Permanente will cover emergency services at Scripps Memorial Hospital in La Jolla. Kaiser/Scripps Partnership for Cardiac Care
"Emergency medical condition" coverage: You are covered for emergency medical conditions anywhere in the world, at both in-network and out-of-network facilities, including Scripps.
Cost-sharing: You should only be responsible for your plan's in-network cost-sharing amount (copayments, coinsurance, and deductibles) for covered emergency services. California and federal "No Surprises Act" laws protect you from balance billing in these situations.
Action required: If you have a medical emergency, you should call emergency services or go to the nearest emergency department immediately. Once your condition is stable, you or the hospital should notify Kaiser Permanente to coordinate post-stabilization care and avoid potential issues with coverage.
Non-Emergency Care at Scripps Hospital
Coverage for non-emergency, routine, or urgent care at Scripps is generally not covered, or is covered at a much higher cost, unless it falls under a specific partnership.
Kaiser/Scripps Partnership for Cardiac Care: Kaiser Permanente has a long-standing partnership with Scripps Health (specifically at the Prebys Cardiovascular Institute at Scripps Memorial Hospital La Jolla) to provide exclusive cardiac surgery and interventional cardiology services to Kaiser Permanente members in San Diego County. For these specific services, you pay your usual in-network cost share.
Routine/Urgent Care: For all other routine or non-emergent specialist care, Scripps is generally considered an out-of-network provider.
Standard HMO Plans: Most standard Kaiser Permanente HMO plans do not offer out-of-network benefits for routine care within the service area. You would be responsible for the full cost.
"Out-of-Area" (OOA) or "Plus Choice" Plans: If you have a specific plan variation like an Out-of-Area PPO or a "KP Plus Choice" plan, you may have limited out-of-network benefits (e.g., a certain number of visits per year) but would still face higher out-of-pocket costs and possibly need to pay upfront and file a claim for reimbursement.
Prior Authorization/Referral: For planned, non-emergency services, you generally need a referral from a Kaiser Permanente doctor and prior authorization for services from an out-of-network facility to be covered.
Summary of Actions to Take
For an emergency: Go to Scripps ER immediately. Ensure you or the hospital contacts Kaiser Permanente once the condition is stable.
For cardiac care: Follow your Kaiser Permanente physician's referral to Scripps as this is part of a specific in-network partnership.
For all other care:
Confirm coverage: Always call the Member Services number on the back of your Kaiser Permanente ID card before seeking non-emergency care at Scripps to confirm your specific plan's benefits and pre-authorization requirements.
Inquire about single-case agreements: In rare cases, if Kaiser Permanente cannot provide a necessary service in-network, a case-by-case agreement might be possible, but this requires working through Member Services and typically a strong medical justification.
Getting care away from home | Kaiser Permanente
(KPIC) PPO. * 1Your health benefits are self-insured by your employer, union, or Plan sponsor. Kaiser Permanente Insurance Company...

Travel Care Outside of Southern California | Kaiser Permanente
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Keywords when talking to membership services-emergency and urgently needed.
“ Kaiser provides coverage for services outside of the network only in cases of emergency and urgently needed services.”

[ucnet.universityofcalifornia.edu]

Or…

[healthy.kaiserpermanente.org]

[healthy.kaiserpermanente.org]

[healthy.kaiserpermanente.org]
In Austin and have an “emergency “? [healthy.kaiserpermanente.org]

[www.opm.gov]

Thank you Susan for taking the time explaining all of that. I had no idea Kaiser even had a PPO plan. Unfortunately, I live in the Sacramento area which is over 500 miles away from La Jolla and my plan is an HMO

Quote
EricY
Thank you Susan for taking the time explaining all of that. I had no idea Kaiser even had a PPO plan. Unfortunately, I live in the Sacramento area which is over 500 miles away from La Jolla and my plan is an HMO

Call up membership services. If it’s either urgent or an emergency, you can arrange out of pocket. Even if it’s not urgent, you have rights. I’m not going into details but our family took use of getting Kaiser to allow out of network hospitals, and surgeries and treatments many times. You need to be your own aggressive advocate.

I do not recommend Los Robles. I had 4 ablations there plus a pacemaker and a watchman and angio at their cath lab. Hospital is physically nice. Everyone gets a private room with an individual HEPA system AC/heat to cut down on respiratory infections. Food is great. You can request a small fridge and in my situation, food was purchased from Whole Foods if you have allergies. The kitchen is very accommodating. However their cath lab isn’t, according to Natale, as high tech as his Austin facility. Wouldn’t you want the best mapping imaging?

Plus at Los Robles, Natale has only one NP and nobody else on call if she is unavailable, and no attending or rotating help from his office in case you get a complication and extend your admission after Natale returns back to Austin since he is only there one half week a month. You get assigned a hospitalist who isn’t a cardiologist when the NP isn’t available-weekends, nights, vacations and holidays.

Someone on this site also lives in N California and he had a successful ablation (natale) with no complications at Los Robles. He was fortunate . With 6 procedures and surgeries I know about what is the protocol when your team is not available. This fellow participant of this site first ablation was in Northern California if I recall when Natale practiced near you. It lasted a long time. Did you get any references for the SF Bay area?

La Jolla is a beautiful place to recuperate and have a vacation. It’s still closer to you than Austin and you can get Dr Natale and with persistence, Kaiser will pay. The following are transportation choices:
[www.rome2rio.com]



Edited 1 time(s). Last edit at 01/22/2026 06:34AM by susan.d.